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Volume 35 (2); May 2020
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Review Article
Basic science and research
Sepsis-induced cardiac dysfunction: a review of pathophysiology
Reverien Habimana, Insu Choi, Hwa Jin Cho, Dowan Kim, Kyoseon Lee, Inseok Jeong
Acute Crit Care. 2020;35(2):57-66.   Published online May 31, 2020
DOI: https://doi.org/10.4266/acc.2020.00248
  • 14,447 View
  • 953 Download
  • 44 Web of Science
  • 48 Crossref
AbstractAbstract PDF
It is well known that cardiac dysfunction in sepsis is associated with significantly increased mortality. The pathophysiology of sepsis-induced cardiac dysfunction can be summarized as involving impaired myocardial circulation, direct myocardial depression, and mitochondrial dysfunction. Impaired blood flow to the myocardium is associated with microvascular dysfunction, impaired endothelium, and ventriculo-arterial uncoupling. The mechanisms behind direct myocardial depression consist of downregulation of β-adrenoceptors and several myocardial suppressants (such as cytokine and nitric oxide). Recent research has highlighted that mitochondrial dysfunction, which results in energy depletion, is a major factor in sepsis-induced cardiac dysfunction. Therefore, the authors summarize the pathophysiological process of cardiac dysfunction in sepsis based on the results of recent studies.

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Original Articles
Cardiology
Predictors and outcomes of sepsis-induced cardiomyopathy in critically ill patients
Myung Jin Song, Sang Hoon Lee, Ah Young Leem, Song Yee Kim, Kyung Soo Chung, Eun Young Kim, Ji Ye Jung, Young Ae Kang, Young Sam Kim, Joon Chang, Moo Suk Park
Acute Crit Care. 2020;35(2):67-76.   Published online May 15, 2020
DOI: https://doi.org/10.4266/acc.2020.00024
  • 6,849 View
  • 219 Download
  • 10 Web of Science
  • 11 Crossref
AbstractAbstract PDF
Background
Sepsis-induced cardiomyopathy (SIC) occurs frequently in critically ill patients, but the clinical features and prognostic impact of SIC on sepsis outcome remain controversial. Here, we investigated the predictors and outcomes of SIC.
Methods
Patients admitted to a single medical intensive care unit from June 2016 to September 2017 were retrospectively reviewed. SIC was diagnosed by ejection fraction (EF) <50% and ≥10% decrease in baseline EF that recovered within 2 weeks.
Results
In total, 342 patients with sepsis met the inclusion criteria, and 49 patients (14.3%) were diagnosed with SIC; the latter were compared with 259 patients whose EF was not deteriorated by sepsis (non-SIC). Low systolic blood pressure and increased left ventricular end-diastolic diameter (LVEDD) were identified as predictors of SIC. SIC and non-SIC patients did not differ significantly in terms of 28-day all-cause mortality (24.5% vs. 26.3%, P=0.936). Acute Physiology and Chronic Health Evaluation II (APACHE II; hazard ratio [HR], 1.10; 95% confidential interval [CI], 1.02 to 1.18; P=0.009) and delta neutrophil index (DNI; HR, 1.02; 95% CI, 1.00 to 1.08; P=0.026) were independent risk factors for 28-day mortality with SIC. DNI, APACHE II, and lactate were identified as risk factors for 28-day mortality in sepsis patients as a whole.
Conclusions
SIC was not associated with increased mortality compared to non-SIC. Low systolic blood pressure and increased LVEDD were predictors of SIC. High APACHE II score and elevated DNI, which reflect sepsis severity, predict 28-day all-cause mortality.

Citations

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Rapid response system
Effectiveness of a daytime rapid response system in hospitalized surgical ward patients
Eunjin Yang, Hannah Lee, Sang-Min Lee, Sulhee Kim, Ho Geol Ryu, Hyun Joo Lee, Jinwoo Lee, Seung-Young Oh
Acute Crit Care. 2020;35(2):77-86.   Published online May 13, 2020
DOI: https://doi.org/10.4266/acc.2019.00661
  • 6,444 View
  • 212 Download
  • 6 Web of Science
  • 8 Crossref
AbstractAbstract PDFSupplementary Material
Background
Clinical deteriorations during hospitalization are often preventable with a rapid response system (RRS). We aimed to investigate the effectiveness of a daytime RRS for surgical hospitalized patients.
Methods
A retrospective cohort study was conducted in 20 general surgical wards at a 1,779-bed University hospital from August 2013 to July 2017 (August 2013 to July 2015, pre-RRS-period; August 2015 to July 2017, post-RRS-period). The primary outcome was incidence of cardiopulmonary arrest (CPA) when the RRS was operating. The secondary outcomes were the incidence of total and preventable cardiopulmonary arrest, in-hospital mortality, the percentage of “do not resuscitate” orders, and the survival of discharged CPA patients.
Results
The relative risk (RR) of CPA per 1,000 admissions during RRS operational hours (weekdays from 7 AM to 7 PM) in the post-RRS-period compared to the pre-RRS-period was 0.53 (95% confidence interval [CI], 0.25 to 1.13; P=0.099) and the RR of total CPA regardless of RRS operating hours was 0.76 (95% CI, 0.46 to 1.28; P=0.301). The preventable CPA after RRS implementation was significantly lower than that before RRS implementation (RR, 0.31; 95% CI, 0.11 to 0.88; P=0.028). There were no statistical differences in in-hospital mortality and the survival rate of patients with in-hospital cardiac arrest. Do-not-resuscitate decisions significantly increased during after RRS implementation periods compared to pre-RRS periods (RR, 1.91; 95% CI, 1.40 to 2.59; P<0.001).
Conclusions
The day-time implementation of the RRS did not significantly reduce the rate of CPA whereas the system effectively reduced the rate of preventable CPA during periods when the system was operating.

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Pediatric
Effects of the presence of a pediatric intensivist on treatment in the pediatric intensive care unit
Jung Eun Kwon, Da Eun Roh, Yeo Hyang Kim
Acute Crit Care. 2020;35(2):87-92.   Published online May 12, 2020
DOI: https://doi.org/10.4266/acc.2019.00752
  • 4,331 View
  • 97 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract PDF
Background
There are few studies on the effect of intensivist staffing in pediatric intensive care units (PICUs) in Korea. We aimed to evaluate the effect of pediatric intensivist staffing on treatment outcomes in a Korean hospital PICU.
Methods
We analyzed two time periods according to pediatric intensivist staffing: period 1, between November 2015 to January 2017 (no intensivist staffing, n=97) and period 2, between February 2017 to February 2018 (intensivists staffing, n=135).
Results
Median age at admission was 5.4 years (range, 0.7–10.3 years) in period 1 and 3.6 years (0.2–5.1 years) in period 2 (P=0.013). The bed occupancy rate decreased in period 2 (75%; 73%–88%) compared to period 1 (89%; 81%–94%; P=0.015). However, the monthly bed turnover rate increased in period 2 (2.2%; 1.9%–2.7%) compared to period 1 (1.5%, 1.1%– 1.7%; P=0.005). In both periods, patients with chronic neurologic illness were the most common. Patients with cardiovascular problems were more prevalent in period 2 than period 1 (P=0.008). Daytime admission occurred more frequently in period 2 than period 1 (63% vs. 39%, P<0.001). The length of PICU stay, parameters related with mechanical ventilation and tracheostomy, and pediatric Sequential Organ Failure Assessment score were not different between periods. Sudden cardiopulmonary resuscitations occurred in two cases during period 1, but no case occurred during period 2.
Conclusions
Pediatric intensivist staffing in the PICU may affect efficient ICU operations.

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    Ah Young Choi, Esther Park
    BMC Pediatrics.2023;[Epub]     CrossRef
  • Impact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit
    Sung Jun Ko, Jaeyoung Cho, Sun Mi Choi, Young Sik Park, Chang-Hoon Lee, Chul-Gyu Yoo, Jinwoo Lee, Sang-Min Lee, Robert Jeenchen Chen
    PLOS ONE.2021; 16(10): e0259092.     CrossRef
  • Intensivists in the pediatric intensive care unit: conductors for better operational efficiency
    June Dong Park
    Acute and Critical Care.2020; 35(2): 115.     CrossRef
CPR/Resuscitation
Measurement of mean systemic filling pressure after severe hemorrhagic shock in swine anesthetized with propofol-based total intravenous anesthesia: implications for vasopressor-free resuscitation
Athanasios Chalkias, Anastasios Koutsovasilis, Eleni Laou, Apostolos Papalois, Theodoros Xanthos
Acute Crit Care. 2020;35(2):93-101.   Published online April 20, 2020
DOI: https://doi.org/10.4266/acc.2019.00773
  • 6,545 View
  • 153 Download
  • 8 Web of Science
  • 8 Crossref
AbstractAbstract PDF
Background
Mean systemic filling pressure (Pmsf) is a quantitative measurement of a patient’s volume status and represents the tone of the venous reservoir. The aim of this study was to estimate Pmsf after severe hemorrhagic shock and cardiac arrest in swine anesthetized with propofol-based total intravenous anesthesia, as well as to evaluate Pmsf’s association with vasopressor-free resuscitation.
Methods
Ten healthy Landrace/Large-White piglets aged 10–12 weeks with average weight 20±1 kg were used in this study. The protocol was divided into four distinct phases: stabilization, hemorrhagic, cardiac arrest, and resuscitation phases. We measured Pmsf at 5–7.5 seconds after the onset of cardiac arrest and then every 10 seconds until 1 minute postcardiac arrest. During resuscitation, lactated Ringers was infused at a rate that aimed for a mean right atrial pressure of ≤4 mm Hg. No vasopressors were used.
Results
The mean volume of blood removed was 860±20 ml (blood loss, ~61%) and the bleeding time was 43.2±2 minutes while all animals developed pulseless electrical activity. Mean Pmsf was 4.09±1.22 mm Hg, and no significant differences in Pmsf were found until 1 minute postcardiac arrest (4.20±0.22 mm Hg at 5–7.5 seconds and 3.72±0.23 mm Hg at 55– 57.5 seconds; P=0.102). All animals achieved return of spontaneous circulation (ROSC), with mean time to ROSC being 6.1±1.7 minutes and mean administered volume being 394±20 ml.
Conclusions
For the first time, Pmsf was estimated after severe hemorrhagic shock. In this study, Pmsf remained stable during the first minute post-arrest. All animals achieved ROSC with goal-directed fluid resuscitation and no vasopressors.

Citations

Citations to this article as recorded by  
  • COMPARISON BETWEEN ACTIVE ABDOMINAL COMPRESSION-DECOMPRESSION CARDIOPULMONARY RESUSCITATION AND STANDARD CARDIOPULMONARY RESUSCITATION IN ASPHYCTIC CARDIAC ARREST RATS WITH MULTIPLE RIB FRACTURES
    Zhichu Dai, Sisen Zhang, Hongyu Wang, Liwei He, Jiankun Liao, Xuanyu Wu
    Shock.2024; 61(2): 266.     CrossRef
  • Effects of Vasopressin Receptor Agonists during the Resuscitation of Hemorrhagic Shock: A Systematic Review and Meta-Analysis of Experimental and Clinical Studies
    Eleni Laou, Nikolaos Papagiannakis, Androniki Papadopoulou, Theodora Choratta, Minas Sakellakis, Mariachiara Ippolito, Ioannis Pantazopoulos, Andrea Cortegiani, Athanasios Chalkias
    Journal of Personalized Medicine.2023; 13(7): 1143.     CrossRef
  • Hemodynamic Effects of Cardiovascular Medications in a Normovolemic and Hemorrhaged Yorkshire-cross Swine Model
    Jacob H Cole, Scott B Hughey, Phillip G Geiger, Kamala J Rapp-Santos, Gregory J Booth
    Comparative Medicine.2022; 72(1): 38.     CrossRef
  • Determinants of venous return in steady-state physiology and asphyxia-induced circulatory shock and arrest: an experimental study
    Athanasios Chalkias, Eleni Laou, Nikolaos Papagiannakis, Giolanda Varvarousi, Dimitrios Ragias, Anastasios Koutsovasilis, Demosthenes Makris, Dimitrios Varvarousis, Nicoletta Iacovidou, Ioannis Pantazopoulos, Theodoros Xanthos
    Intensive Care Medicine Experimental.2022;[Epub]     CrossRef
  • Assessment of Dynamic Changes in Stressed Volume and Venous Return during Hyperdynamic Septic Shock
    Athanasios Chalkias, Eleni Laou, Nikolaos Papagiannakis, Vaios Spyropoulos, Evaggelia Kouskouni, Kassiani Theodoraki, Theodoros Xanthos
    Journal of Personalized Medicine.2022; 12(5): 724.     CrossRef
  • A Critical Appraisal of the Effects of Anesthetics on Immune-system Modulation in Critically Ill Patients With COVID-19
    Athanasios Chalkias, Erin F. Barreto, Eleni Laou, Konstantina Kolonia, Marc H. Scheetz, Konstantinos Gourgoulianis, Ioannis Pantazopoulos, Theodoros Xanthos
    Clinical Therapeutics.2021; 43(3): e57.     CrossRef
  • Resuscitative Effect of Centhaquine (Lyfaquin®) in Hypovolemic Shock Patients: A Randomized, Multicentric, Controlled Trial
    Anil Gulati, Dinesh Jain, Nilesh Radheshyam Agrawal, Prashant Rahate, Rajat Choudhuri, Soumen Das, Deba Prasad Dhibar, Madhav Prabhu, Sameer Haveri, Rohit Agarwal, Manish S. Lavhale
    Advances in Therapy.2021; 38(6): 3223.     CrossRef
  • A Multicentric, Randomized, Controlled Phase III Study of Centhaquine (Lyfaquin®) as a Resuscitative Agent in Hypovolemic Shock Patients
    Anil Gulati, Rajat Choudhuri, Ajay Gupta, Saurabh Singh, S. K. Noushad Ali, Gursaran Kaur Sidhu, Parvez David Haque, Prashant Rahate, Aditya R. Bothra, Gyan P. Singh, Sanjiv Maheshwari, Deepak Jeswani, Sameer Haveri, Apurva Agarwal, Nilesh Radheshyam Agra
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Trauma
Inclusion of lactate level measured upon emergency room arrival in trauma outcome prediction models improves mortality prediction: a retrospective, single-center study
Jonghwan Moon, Kyungjin Hwang, Dukyong Yoon, Kyoungwon Jung
Acute Crit Care. 2020;35(2):102-109.   Published online May 31, 2020
DOI: https://doi.org/10.4266/acc.2019.00780
  • 4,297 View
  • 154 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Background
This study aimed to develop a model for predicting trauma outcomes by adding arterial lactate levels measured upon emergency room (ER) arrival to existing trauma injury severity scoring systems.
Methods
We examined blunt trauma cases that were admitted to our hospital during 2010– 2014. Eligibility criteria were cases with an Injury Severity Score of ≥9, complete Trauma and Injury Severity Score (TRISS) variable data, and lactate levels that were assessed upon ER arrival. Survivor and non-survivor groups were compared and lactate-based prediction models were generated using logistic regression. We compared the predictive performances of traditional prediction models (Revised Trauma Score [RTS] and TRISS) and lactate-based models using the area under the curve (AUC) of receiver operating characteristic curves.
Results
We included 829 patients, and the in-hospital mortality rate among these patients was 21.6%. The model that used lactate levels and age provided a significantly better AUC value than the RTS model. The model with lactate added to the TRISS variables provided the highest Youden J statistic, with 86.0% sensitivity and 70.8% specificity at a cutoff value of 0.15, as well as the highest predictive value, with a significantly higher AUC than the TRISS.
Conclusions
These findings indicate that lactate testing upon ER arrival may help supplement or replace traditional physiological parameters to predict mortality outcomes among Korean trauma patients. Adding lactate levels also appears to improve the predictive abilities of existing trauma outcome prediction models.

Citations

Citations to this article as recorded by  
  • Plasma interleukin responses as predictors of outcome stratification in patients after major trauma: a prospective observational two centre study
    Matthew Allan Jones, James Hanison, Renata Apreutesei, Basmah Allarakia, Sara Namvar, Deepa Shruthi Ramaswamy, Daniel Horner, Lucy Smyth, Richard Body, Malachy Columb, Mahesan Nirmalan, Niroshini Nirmalan
    Frontiers in Immunology.2023;[Epub]     CrossRef
  • Admission Lactate and Base Deficit in Predicting Outcomes of Pediatric Trauma
    Yo Huh, Yura Ko, Kyungjin Hwang, Kyoungwon Jung, Yoon-ho Cha, Yoo Jin Choi, Jisook Lee, Jung Heon Kim
    Shock.2021; 55(4): 495.     CrossRef
Brief Communication
Intensivist/Policy
Experience of augmenting critical care capacity in Daegu during COVID-19 incident in South Korea
Je Hyeong Kim, Suk-Kyung Hong, Younghwan Kim, Ho Geol Ryu, Chi-Min Park, Young Seok Lee, Sung Jin Hong
Acute Crit Care. 2020;35(2):110-114.   Published online May 31, 2020
DOI: https://doi.org/10.4266/acc.2020.00275
  • 6,118 View
  • 162 Download
  • 7 Web of Science
  • 8 Crossref
PDF

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  • The Activities and Roles of Trauma Surgeons in the Treatment of COVID-19 Patients
    Younghwan Kim, Seok Hwa Youn
    Journal of Acute Care Surgery.2023; 13(2): 43.     CrossRef
  • Inhalation of Origanum majorana L. essential oil while working reduces perceived stress and anxiety levels of nurses in a COVID-19 intensive care unit: a randomized controlled trial
    Sang Wook Lee, You Kyoung Shin, Jeong-Min Lee, Geun Hee Seol
    Frontiers in Psychiatry.2023;[Epub]     CrossRef
  • What happened during the period from senior medical students’ withdrawal of their applications to take the Korean Medical Licensing Examination in August 2020 to their taking the licensing examination in February 2021
    Sun Huh
    Journal of Educational Evaluation for Health Professions.2022; 19: 3.     CrossRef
  • Comparison of clinical characteristics and hospital mortality in critically ill patients without COVID-19 before and during the COVID-19 pandemic: a multicenter, retrospective, propensity score-matched study
    Sua Kim, Hangseok Choi, Jae Kyeom Sim, Won Jai Jung, Young Seok Lee, Je Hyeong Kim
    Annals of Intensive Care.2022;[Epub]     CrossRef
  • Correlation Between Third Dose of COVID-19 Vaccines and Regional Case Fatality Rates During the Omicron Wave in Korea
    Youngook Jang, In Joong Kim, Sung-Sil Moon, Sun Bean Kim, Jacob Lee
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Socioeconomic disparity and the risk of contracting COVID-19 in South Korea: an NHIS-COVID-19 database cohort study
    Tak Kyu Oh, Jae-Wook Choi, In-Ae Song
    BMC Public Health.2021;[Epub]     CrossRef
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    Dawn M. Bravata, Anthony J. Perkins, Laura J. Myers, Greg Arling, Ying Zhang, Alan J. Zillich, Lindsey Reese, Andrew Dysangco, Rajiv Agarwal, Jennifer Myers, Charles Austin, Ali Sexson, Samuel J. Leonard, Sharmistha Dev, Salomeh Keyhani
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  • Impact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit
    Sung Jun Ko, Jaeyoung Cho, Sun Mi Choi, Young Sik Park, Chang-Hoon Lee, Chul-Gyu Yoo, Jinwoo Lee, Sang-Min Lee, Robert Jeenchen Chen
    PLOS ONE.2021; 16(10): e0259092.     CrossRef
Editorial
Pediatric
Intensivists in the pediatric intensive care unit: conductors for better operational efficiency
June Dong Park
Acute Crit Care. 2020;35(2):115-116.   Published online May 31, 2020
DOI: https://doi.org/10.4266/acc.2020.00276
  • 3,598 View
  • 109 Download
PDF
Case Reports
Pulmonary
Right ventricular assist device with an oxygenator using extracorporeal membrane oxygenation as a bridge to lung transplantation in a patient with severe respiratory failure and right heart decompensation
Dong Kyu Oh, Tae Sun Shim, Kyung-Wook Jo, Seung-Il Park, Dong Kwan Kim, Sehoon Choi, Geun Dong Lee, Sung-Ho Jung, Pil-Je Kang, Sang-Bum Hong
Acute Crit Care. 2020;35(2):117-121.   Published online April 8, 2019
DOI: https://doi.org/10.4266/acc.2018.00416
  • 9,848 View
  • 281 Download
  • 16 Web of Science
  • 21 Crossref
AbstractAbstract PDF
Right heart decompensation is a fatal complication in patients with respiratory failure, particularly in those transitioned to lung transplantation using veno-venous extracorporeal membrane oxygenation (V-V ECMO). In these patients, veno-arterial (V-A ECMO) or veno-arterialvenous extracorporeal membrane oxygenation (V-AV ECMO) is used to support both cardiac and respiratory function. However, these processes may increase the risk of device-related complications such as bleeding, thromboembolism, and limb ischemia. In the present case, a 64-year-old male patient with idiopathic pulmonary fibrosis developed respiratory failure and commenced treatment with V-V ECMO as a bridge to lung transplantation. Unfortunately, the patient developed right heart decompensation and required both cardiac and respiratory support during treatment with V-V ECMO. Instead of adding arterial cannulation, he was switched to a novel configuration, a right ventricular assist device with an oxygenator (Oxy- RVAD) using ECMO, with drainage cannulation from the femoral vein and return cannulation to the main pulmonary artery. The patient was successfully bridged to lung transplantation without serious complications after 10 days of Oxy-RVAD support. To the best of our knowledge, this is an extreme rare and challenging case of Oxy-RVAD using ECMO in a patient successfully bridged to lung transplantation.

Citations

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    John Arthur McClung, William H. Frishman, Wilbert S. Aronow
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    Asad Ali Usman, Audrey Elizabeth Spelde, Wasim Lutfi, Jacob T. Gutsche, William J. Vernick, Omar Toubat, Salim E. Olia, Edward Cantu, Andrew Courtright, Maria M. Crespo, Joshua Diamond, Mauer Biscotti, Christian A. Bermudez
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    Juliette Beaulieu, Christine Vu, Sanjog Kalra, Hamza Ouazani Chahdi, Julie Cousineau, Alexis Matteau, Samer Mansour, E. Marc Jolicoeur, Sabrina Jacques, Bénédicte Nauche, Renata Podbielski, Pasquale Ferraro, Charles Poirier, Brian J. Potter
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    Ga Young Yoo, June Lee, Seok Beom Hong, Do Yeon Kim
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    Sheena MacFarlane, Vanessa Lee, Adrienne H. Simonds, Samantha Alvarez, Samantha Carty, Kevin H. Ewers, Victoria R. Kelly, Parker Linden, Amanda L. Moskal
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    Hye-ji Han, Bongjin Lee, Won Jin Jang, Ji Won Lee, Jin Hee Kim, Sungkyu Cho, June Dong Park
    Pediatric Emergency Medicine Journal.2023; 10(4): 175.     CrossRef
  • Right Ventricular Assist Device With Extracorporeal Membrane Oxygenation for Bridging Right Ventricular Heart Failure to Lung Transplantation: A Single-Center Case Series and Literature Review
    Jae Guk Lee, Chuiyong Pak, Dong Kyu Oh, Ho Cheol Kim, Pil-Je Kang, Geun Dong Lee, Se Hoon Choi, Sung-Ho Jung, Sang-Bum Hong
    Journal of Cardiothoracic and Vascular Anesthesia.2022; 36(6): 1686.     CrossRef
  • Advanced Circulatory Support and Lung Transplantation in Pulmonary Hypertension
    Marie M. Budev, James J. Yun
    Cardiology Clinics.2022; 40(1): 129.     CrossRef
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    Heather Torbic, Benjamin Hohlfelder, Sudhir Krishnan, Adriano R. Tonelli
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    Varunsiri Atti, Mahesh Anantha Narayanan, Brijesh Patel, Sudarshan Balla, Aleem Siddique, Scott Lundgren, Poonam Velagapudi
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  • Comprehensive Monitoring in Patients With Dual Lumen Right Atrium to Pulmonary Artery Right Ventricular Assist Device
    Asad A. Usman, Audrey E. Spelde, Michael Ibrahim, Marisa Cevasco, Christian Bermudez, Emily MacKay, Sameer Khandhar, Wilson Szeto, William Vernick, Jacob Gutsche
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  • Percutaneous Pulmonary Artery Cannulation to Treat Acute Secondary Right Heart Failure While on Veno-venous Extracorporeal Membrane Oxygenation
    Kelly M. Ivins-O’Keefe, Michael S. Cahill, Arthur R. Mielke, Michal J. Sobieszczyk, Valerie G. Sams, Phillip E. Mason, Matthew D. Read
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  • The ProtekDuo for percutaneous V-P and V-VP ECMO in patients with COVID-19 ARDS
    Ahmed M El Banayosy, Aly El Banayosy, Joseph M Brewer, Mircea R Mihu, Jaclyn M Chidester, Laura V Swant, Robert S Schoaps, Ammar Sharif, Marc O Maybauer
    The International Journal of Artificial Organs.2022; 45(12): 1006.     CrossRef
  • Critical Care Management of the Patient with Pulmonary Hypertension
    Christopher J. Mullin, Corey E. Ventetuolo
    Clinics in Chest Medicine.2021; 42(1): 155.     CrossRef
  • Successful Lung Transplantation After 213 Days of Extracorporeal Life Support: Role of Oxygenator-Right Ventricular Assist Device
    Jae Kyeom Sim, Kyeongman Jeon, Gee Young Suh, Suryeun Chung, Yang Hyun Cho
    ASAIO Journal.2021; 67(7): e127.     CrossRef
  • Oxy-right Ventricular Assist Device for Bridging of Right Heart Failure to Lung Transplantation
    Sung Kwang Lee, Do Hyung Kim, Woo Hyun Cho, Hye Ju Yeo
    Transplantation.2021; 105(7): 1610.     CrossRef
  • Interventional and Surgical Treatments for Pulmonary Arterial Hypertension
    Tomasz Stącel, Magdalena Latos, Maciej Urlik, Mirosław Nęcki, Remigiusz Antończyk, Tomasz Hrapkowicz, Marcin Kurzyna, Marek Ochman
    Journal of Clinical Medicine.2021; 10(15): 3326.     CrossRef
  • Intraoperative Management of Adult Patients on Extracorporeal Membrane Oxygenation: an Expert Consensus Statement From the Society of Cardiovascular Anesthesiologists—Part I, Technical Aspects of Extracorporeal Membrane Oxygenation
    Michael A. Mazzeffi, Vidya K. Rao, Jeffrey Dodd-o, Jose Mauricio Del Rio, Antonio Hernandez, Mabel Chung, Amit Bardia, Rebecca M. Bauer, Joseph S. Meltzer, Sree Satyapriya, Raymond Rector, James G. Ramsay, Jacob Gutsche
    Journal of Cardiothoracic and Vascular Anesthesia.2021; 35(12): 3496.     CrossRef
  • Intraoperative Management of Adult Patients on Extracorporeal Membrane Oxygenation: An Expert Consensus Statement From the Society of Cardiovascular Anesthesiologists—Part I, Technical Aspects of Extracorporeal Membrane Oxygenation
    Michael A. Mazzeffi, Vidya K. Rao, Jeffrey Dodd-o, Jose Mauricio Del Rio, Antonio Hernandez, Mabel Chung, Amit Bardia, Rebecca M. Bauer, Joseph S. Meltzer, Sree Satyapriya, Raymond Rector, James G. Ramsay, Jacob Gutsche
    Anesthesia & Analgesia.2021; 133(6): 1459.     CrossRef
Pulmonary
Lung injury associated with inhalation of effective microorganism blends
Jee-min Kim, Yoon Jin Kwak, Ho Il Yoon
Acute Crit Care. 2020;35(2):122-126.   Published online April 8, 2019
DOI: https://doi.org/10.4266/acc.2018.00332
  • 10,081 View
  • 122 Download
AbstractAbstract PDF
Since 2009, effective microorganisms (EMs) have been supplied by the local government to the citizens of Seongnam, Korea, for various environment-protective uses including manufacturing detergents, cosmetics and humidifier disinfectants. A 68-year-old man who had placed an EM blends into a humidifier for inhalation visited the emergency room with complaints of fever and dyspnea. He was in a shock state with hypoxia. Chest computed tomography revealed diffuse ground-glass opacities that were dominant in the bilateral upper lobes. Fiberoptic bronchoscopy with bronchoalveolar lavage and transbronchial lung biopsy was performed. Bronchoalveolar lavage fluid analysis and biopsy findings were consistent with alveolar hemorrhage. All microbiological and virological test results were negative. His symptoms and radiographic opacities had improved markedly after several days of conservative care, and he was discharged healthy after 1 week of hospital stay.
Letter to the Editor
Pulmonary
Is percutaneous dilatational tracheostomy with bronchoscopic guidance better than without?
Jinsun Chang, Hong-Joon Shin, Yong-Soo Kwon, Yu-Il Kim, Sung-Chul Lim, Tae-Ok Kim
Acute Crit Care. 2020;35(2):127-129.   Published online May 31, 2020
DOI: https://doi.org/10.4266/acc.2020.00101
  • 3,770 View
  • 106 Download
PDF

ACC : Acute and Critical Care